The Facts About Lymphedema and Breast Cancer

This information will help you understand what lymphedema is and your risk for developing it.

During surgery for breast cancer, your doctor may remove some of your lymph nodes to see if the cancer has spread. In some cases, this can lead to damage to the lymphatic system.

Your lymphatic system is made up of lymphatic vessels, lymph nodes, and lymphatic fluid.

  • Lymphatic vessels are tiny tubes, similar to blood vessels, which carry fluid to and from your lymph nodes.
  • Lymph nodes are small bean-shaped glands located along your lymphatic vessels. Your lymph nodes filter out bacteria, viruses, cancer cells, and other waste products.
  • Lymphatic fluid is the clear fluid that travels though your lymphatic system. It carries cells that help fight infections and other diseases.
  • Axillary lymph nodes are a group of nodes found in the armpit that drain the lymph fluid from the breast and arm. The number of nodes varies from person to person.
  • Sentinel lymph node(s) are the first node(s) in your armpit that receive drainage from the breast tumor.

When the lymphatic system is damaged it may not drain properly, causing lymphatic fluid to build up. The extra fluid causes swelling called lymphedema. Lymphedema can occur in the arm, hand, breast, or torso on the side where your lymph nodes were removed.

Understanding Your Risk of Developing Lymphedema

Most women will not develop lymphedema, but some will. It’s difficult to determine the risk of developing lymphedema because:

  • There is no standard test for diagnosing lymphedema.
  • Disruption of lymph nodes affects people differently.
  • Lymphedema can develop soon after surgery, or years later.
  • Current cases of lymphedema can be caused by older treatment methods.

Studies show the risk of developing lymphedema varies based on how the lymph nodes are removed. There are 2 types of surgeries used to remove lymph nodes:

  • During a sentinel lymph node biopsy, between one and a few lymph nodes are removed to check for cancer. With a sentinel lymph node biopsy, studies show the risk of developing lymphedema is very low.
  • During an axillary lymph node dissection, a wider incision is made and more lymph nodes are removed from the armpit. This is done to remove additional lymph nodes that may have cancer. With axillary lymph node dissection, studies show the risk of developing lymphedema is higher than sentinel node biopsy.

Conditions that damage the lymphatic system can increase your risk of developing lymphedema, such as:

  • Radiation therapy to the armpit
  • An infection after surgery
  • Severe injury to your surgical area (such as a serious burn or wound)
  • Tumor growth
  • Weight gain after treatment
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Reducing Your Risk of Developing Lymphedema

There is no way to know who will develop lymphedema, but there are things you can do to reduce your risk:

  • Try to maintain your normal weight, or safely work towards a more ideal body weight.
  • Exercise and stretch your muscles on a regular basis. When you resume exercise and activity, make sure to build up slowly and gradually. If you feel discomfort, stop and take a break. Talk with your doctor or nurse about which exercises are right for you.
  • Try to minimize your risk of infection to your hand and arm. Ask your doctor or nurse how best to care for cuts, scratches, and burns.
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Signs of Lymphedema

Some mild swelling after surgery is normal and will go away with time. You may also feel pain or other sensations, such as twinges and tingling, after surgery. These feelings are common and are not necessarily signs of lymphedema.

If you’re at risk of developing lymphedema, it’s a good idea to watch for signs of it developing. For example:

  • A feeling of heaviness or aching in your breast, arm, hand, or fingers.
  • The skin of your arm, hand, or breast feels tight.
  • Decreased flexibility in your arm, hand, or fingers.
  • Swelling or changes in your skin, such as tightness or pitting (skin that stays indented after being pressed).

If you have any signs of lymphedema, or you’re not sure, it’s important you talk with your doctor or nurse so that a correct diagnosis can be made.

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